B.

Ectopic Pregnancy- implantation outside the uterus/other than the uterus

SITES OF ECTOPIC PREGNANCY

Tubal

Isthmic

Ampullar - most common site

Infundibular

Ovarian

Cervical

Interligamental

Interstitial - most dangerous site

Abdominal - rarest

CAUSES

Salpingitis - inflammation of the fallopian tube (there is obstruction in the inflammed area)

Peritubular adhesions

Kinking

Narrowing of the fallopian tubes

Previous operation on the tube

Tumor

GENERAL SIGN

Sharp stabbing pain in the left or right area of the abdomen (knife-like, piercing, dart-like pain)

Visualization via abdominal UTZ

CLASSIFICATIONS

1. Unruptured Tube
Feeling of missed period (bloated)

Pain

Vaginal bleeding

2. Ruptured Tube

Tachycardia

Cold clammy skin

Cullen's sign (bluish discoloration in the umbilicus)

. PROM - Premature Rupture of Membranes (ruptured before 38 weeks/ruptured before signs of labor)

PPROM: Preterm Premature Rupture of Membranes

RISK FACTORS

Infection - common is UTI

Low socioeconomic conditions

Previous preterm birth

Overdistension of the uterus (grandmultiparity or multifetal pregnancies)

Abruptio Placenta

Cigarette smoking

SIGNS AND SYMPTOMS/ASSESSMENT

Leakage of fluid from the vagina

Followed by signs of labor

PROM - labor begins within 24 hours

PPROM - can be delayed up to a weeks or more

MANAGEMENT

Confirm Diagnosis:

Nitrazine test

Fern test
Pelvic examination

Presence of infection:

Antibiotic therapy

Labor induction (if it is 37 weeks and above)

Prevention:

Tocolytics (MgSO4: given to control contractions)

Bethamethasone - for lung maturity of the baby

COMPLICATIONS

Premature labor and delivery = preterm baby

Infection

Prolapse of the cord

Oligohydramnios (less than 300ml)